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torsemide oral

Lithium/Loop Diuretics

This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.

Medical warning:

Serious. These medicines may interact and cause very harmful effects. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.

How the interaction occurs:

When these two medicines are taken together, your body may not process lithium properly. Your diuretic may interfere with the benefits of lithium.

What might happen:

The effects of lithium may decrease or increase causing either decreased effectiveness or an increase in toxic effects.

What you should do about this interaction:

If your doctor prescribes these medicines together, you may need to have your lithium blood levels checked closely. Contact your doctor as soon as possible if you experience changes in mood, diarrhea, vomiting, ringing in the ears, blurred vision, lack of coordination, unusual drowsiness, seizures, tremor, or loss of consciousness. It may be necessary to change the dose of your lithium or to change your diuretic.Your healthcare professionals (e.g. doctor or pharmacist) may already be aware of this drug interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.

References:

1.Oh TE. Frusemide and lithium toxicity. Anaesth Intensive Care 1977 Feb; 5(1):60-2.
2.Thornton WE, Pray BJ. Lithium intoxication: a report of two cases. Can Psychiatr Assoc J 1975 Jun;20(4):281-2.
3.Hurtig HI, Dyson WL. Letter: Lithium toxicity enhanced by diuresis. N Engl J Med 1974 Mar 28;290(13):748-9.
4.Kerry RJ, Ludlow JM, Owen G. Diuretics are dangerous with lithium. Br Med J 1980 Aug 2;281(6236):371.
5.Huang LG. Lithium intoxication with coadministration of a loop-diuretic. J Clin Psychopharmacol 1990 Jun;10(3):228.
6.Shalmi M, Rasmusen H, Amtorp O, Christensen S. Effect of chronic oral furosemide administration on the 24-hour cycle of lithium clearance and electrolyte excretion in humans. Eur J Clin Pharmacol 1990;38(3):275-80.
7.Saffer D, Coppen A. Frusemide: a safe diuretic during lithium therapy?. J Affect Disord 1983 Nov;5(4):289-92.
8.Crabtree BL, Mack JE, Johnson CD, Amyx BC. Comparison of the effects of hydrochlorothiazide and furosemide on lithium disposition. Am J Psychiatry 1991 Aug;148(8):1060-3.
9.Atherton JC, Green R, Hughes S, McFall V, Sharples JA, Solomon LR, Wilson L. Lithium clearance in man: effects of dietary salt intake, acute changes in extracellular fluid volume, amiloride and frusemide. Clin Sci (Lond) 1987 Dec;73(6):645-51.
10.Colussi G, Rombola G, Surian M, De Ferrari ME, Airaghi C, Benazzi E, Malberti F, Minetti L. Effects of acute administration of acetazolamide and frusemide on lithium clearance in humans. Nephrol Dial Transplant 1989;4(8):707-12.
11.Beutler JJ, Boer WH, Koomans HA, Dorhout Mees EJ. Comparative study of the effects of furosemide, ethacrynic acid and bumetanide on the lithium clearance and diluting segment reabsorption in humans. J Pharmacol Exp Ther 1992 Feb;260(2):768-72.

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